Impact of supportive community linkage intervention for management of breastfeeding problems at community level-a Prospective intervention study.

Rational /gaps in existing knowledge: Many mothers find breastfeeding challenging after leaving the hospital. ANM and CHO are important part of the health system in rural India, if they get strengthened and supported at community level, there is a likelihood of improved breastfeeding practices rates.

Novelty: We will be able to generate evidence and recommend supported community linkage for a few months to the ANM/CHOs by the trainers. An extensive literature review has revealed paucity of data for intervention in India.

**Objective:**To compare the impact of supportive community linkage versus routine training on ANMs and CHOs skills for managing breastfeeding problems. To find the barriers and facilitators for breastfeding in the community.

Methods: The present study will be a prospective intervention study. Two blocks each from district Mohali & district Hoshiarpur will be selected. In both districts; in one randomly selected block (Group-1); all ANMs and CHOs will receive supportive community linkage & routine training, and in another block (Group-2), only routine training for managing breastfeeding problems will be given. All the ANMs and CHOs will receive training over 2 days. At the end of 2nd day, both group’s knowledge will be checked by using a pre-tested, validated, semi-structured questionnaire and skill assessment will be done by pre-identified, hypothetical 10 cases having lactation problems. A pre-tested, validated checklist will be given to both groups for which agreement or disagreement for the correct management will be later made by the investigators other than the study investigator. Group 1 block will receive additional supportive community linkage. Both groups will be followed up till six months after intervention and after 6 months post-test will be done by the same methodology as adopted for the pre-test with skill assessment in the field.